关键词:

肝移植 , 血小板减少症 , 阿伐曲泊帕 , 重组人血小板生成素 , 围手术期治疗

Abstract:

Objective To evaluate the clinical efficacy of avatrombopag in the treatment of severethrombocytopenia during the perioperative period of liver transplantation， and to compare it with recombinant human thrombopoietin （rhTPO） and platelet transfusion. Methods A retrospective analysis was conducted on 88 patientswho developed severe thrombocytopenia after liver transplantation between May 2019 and December 2023 in TongjiHospital， Tongji Medical College， Huazhong University of Science and Technology. Patients were divided into threegroups based on treatment: avatrombopag group （n ＝ 33）， rhTPO group （n ＝ 27）， and platelet transfusion group（n＝28）. The primary endpoint was the effective rate, which was defined as platelet count ＞50×109 /L or an increase＞ 20×109 /L on day 7 post-treatment. Results The avatrombopag group achieved a significantly higher effective rate of 96.97% on day 7 compared to the rhTPO group （70.37%，P ＝ 0.008） and platelet transfusion group （60.71%，P ＜ 0.001）. Platelet counts in the avatrombopag group showed significant improvement from day 3 and reached effective levels by day 5 in most patients. Baseline characteristics were comparable across groups. Conclusion Avatrombopag demonstrates superior efficacy over rhTPO and platelet transfusion in managing severe perioperativethrombocytopenia following liver transplantation， with rapid onset and favorable safety profile. Further multicenter randomized controlled trials are warranted. 

Key words:

Liver transplantation ,  , Thrombocytopenia ,  , Avatrombopag ,  , Recombinant human thrombopoietin,  , Perioperative managemen